Gastroparesis
Condition
(Delayed Gastric Emptying)
Definition
Gastroparesis is when the stomach cannot break down food and move it to the small intestine. With this problem, food either moves too slowly or not at all. This can cause food to harden and lead to blockages. Early treatment can help outcomes.
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Causes
The vagus nerve controls movement of the stomach. The nerve may be damaged because of injury or illness. The muscles of the stomach will then not be able to work as they should.
Risk Factors
This problem is more common in women.
The main risk factor for gastroparesis is diabetes, which can harm nerves. Other things that may raise the risk are:
- Gastroesophageal reflux disease (GERD)
- Surgery that involves the stomach or vagus nerve
- Taking some medicines, such as anticholinergics or opioids
- Viral infection
- Diseases affecting the nerves, muscles, or hormones
- Diseases affecting metabolism—how the body is able to make and use energy
- Anorexia or bulimia
- Radiation therapy or chemotherapy
- Smoking
- Alcohol use
Symptoms
A person with gastroparesis may have:
- A feeling of being full just after they start eating
- Lack of hunger
- Nausea and vomiting
- Weight loss
- Bloating
- Heartburn
- Belly or chest pain
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done.
Blood and urine tests may be done to look for problems.
Images may be taken of the stomach and structures near it. This can be done with:
- Ultrasound
- Barium x-ray or CT scan
- Gastric emptying study—may also be done by MRI scan
Other ways to see the stomach that may be used are:
- Upper GI endoscopy—a thin, lighted tube inserted down the throat to look at the esophagus, stomach, and small intestine
- SmartPill—a pill-sized device that is swallowed to take images of all the digestive system
Treatment
The goal of treatment is to ease symptoms. Any underlying causes of gastroparesis will need to be treated. The doctor may advise:
Prevention
People with diabetes can lower the risk of this problem by following their care plan.
Dietary Changes
Diet changes may need to be made to ease symptoms. This may mean:
- Eating small meals often during the day
- Having a liquid diet
- Limiting high-fat and high-fiber foods
Dietary Changes
Diet changes may need to be made to ease symptoms. This may mean:
- Eating small meals often during the day
- Having a liquid diet
- Limiting high-fat and high-fiber foods
Alternative Nutrition
People with severe symptoms may need to have nutrients delivered directly into the:
- Intestines—a tube is passed through nose, down the throat, and into the intestine. Long term use may require a tube passed through the stomach wall into the intestine.
- Bloodstream—through an IV
Medicine
Medicine may be given to ease symptoms, such as nausea. Other medicines may be given to help the stomach empty. Examples are:
- Metoclopramide
- Erythromycin
Surgery
People with severe symptoms and those who are not helped by other methods may need surgery. This may include removing part of the stomach.
American College of Gastroenterology
American Gastroenterological Association
CANADIAN RESOURCES
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
American College of Gastroenterology
American Gastroenterological Association
CANADIAN RESOURCES
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
References
- Complications of diabetes mellitus. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/complications-of-diabetes-mellitus.
- Gastroparesis. American College of Gastroenterology website. Available at: https://gi.org/topics/gastroparesis.
- Gastroparesis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/gastroparesis.
- Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis.
Contributors
- James Cornell, MD
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